This analysis included 56 myelofibrosis (MF) patients transplanted from family mismatched donor between 2009 and 2015 enrolled in the European Society for Blood and Marrow Transplantation database. The median age was 57years (range, 38 to 72); 75% had primary MF and 25% had secondary MF. JAK2 V617F was mutated in 61%. Donors were HLA mismatched at 2 or more loci. Stem cells were sourced from bone marrow in 66% and peripheral blood in 34%. The median CD34+ cell dose was 4.8 × 106/kg (range, 1.7 to 22.9; n = 43). Conditioning was predominantly myeloablative in 70% and reduced intensity in the remainder. Regimens were heterogeneous with thiotepa, busulfan, fludarabine, and post-transplant cyclophosphamide used in 59%. The incidence of neutrophil engraftment by 28days was 82% (range, 70% to 93%), at a median of 21days (range, 19 to 23). At 2years the cumulative incidence of primary graft failure was 9% (95% CI 1% to 16%) and secondary graft failure was 13% (95% CI 4% to 22%). The cumulative incidence of acute graft-versus-host disease (GVHD) grades II to IV and III to IV was 28% (95% CI 16% to 40%) and 9% (95% CI 2% to 17%) at 100days. The cumulative incidence of chronic GVHD at 1 year was 45% (95% CI 32% to 58%), but the cumulative incidence of death without chronic GVHD by 1 year was 20% (95% CI 10% to 31%). With a median follow-up of 32 months, the 1- and 2-year overall survival was 61% (95% CI 48% to 74%) and 56% (95% CI 41% to 70%), respectively. The 1- and 2- year progression-free survival was 58% (95% CI 45% to 71%) and 43% (95% CI 28% to 58%), respectively, with a 2-year cumulative incidence of relapse of 19% (95% CI 7% to 31%). The 2-year nonrelapse mortality was 38% (95% CI 24% to 51%). This retrospective study of MF allo-SCT using family mismatched donors demonstrated feasibility of the approach, timely neutrophil engraftment in over 80% of cases, and acceptable overall and progression-free survival rates with relapse rates not dissimilar to the unrelated donor setting. However, strategies to minimize the risk of graft failure and the relatively high nonrelapse mortality need to be used, ideally in a multicenter prospective fashion.

Department of Haematological Medicine Guy's and St Thomas' NHS Foundation Trust London United Kingdom

Department of Haematological Medicine Hammersmith Hospital London United Kingdom

Department of Haematology Ospedale San Martino Genova Italy

Department of Hematology and Bone marrow transplantation Hopital St Louis Paris France

Department of Hematology and Hematopoietic Stem Cell Transplantation Instituto Di Ricovero e Cura a Carattere Scientificio San Raffaele Scientific Institute Milano Italy

Department of Hematology Instituto de investigación sanitaria Gregorio Marañon Universidad Complutense Medicina Madrid Spain

Department of Hematology Lille University hospital INSERM U995 Universite de Lille France

Department of Hematology Radboud University Medical Centre Nijmegen The Netherlands

Department of Hematology Transfusion Medicine and Biotechnology Ospedale Civile Pescara Italy

Department of Internal Medicine University Hospital Basel Switzerland

Department of Medical Statistics and Bioinformatics EBMT Statistical Unit Leiden The Netherlands

Department of Medical Statistics and Bioinformatics EBMT Statistical Unit Leiden The Netherlands; Deutsche Knochenmarkspenderdatei Clinical Trials Unit Dresden Germany

Department of Medicine Helsinki University Central Hospital Comprehensive Cancer Center Helsinki Finland

Department of Onco Hematology Transplantation and cell therapy unit Institut Paoli Calmettes Marseille France

Department of Oncology Stem cell transplant unit Medical Park Hospitals Antalya Turkey

Department of Stem Cell Transplantation University Hospital Eppendorf Hamburg Germany

Departmetn of Immuno oncolgy and Rheumatology Universitat Bonn Bonn Germany

Depatment of Hematology and Bone marrow Transplantation Rambam Medical Center Haifa Israel

Division of Hematology Karolinska University Hospital Stockholm Sweden

Hôpitaux Universitaires de Genève Hematology Division and Faculty of Medicine University of Geneva Geneva Switzerland

Institute of Hematology and Blood Transfusion Prague Czech Rep

Internal Medicine Hematology University Hospital Uppsala Sweden

Citace poskytuje Crossref.org

Determinants of survival in myelofibrosis patients undergoing allogeneic hematopoietic cell transplantation